more. made in. your business magazine. welcome to in good shape coming up this week gender medicine why men and women often need different therapies. fixing your teeth when it makes sense to get an adhesive dental prosthesis. i'm working out when you're over white a fitness group shows you how. and here's your host dr carson let's go tot excessive weight is a worldwide problem you as

a regular viewer of in good shape should be a rail fit but some people are so big that the world health organization says that it is a disease called obesity take the cook islands for instance where 50 percent of the inhabitants are morbidly obese well this year i'm not the cook islands this is not sick when going to meet her face on a ts blew up. as head of the obesity old patient clinic for adults that means his patients have a body mass index. of over until. you get your b.m.i. when you take your weight in kilograms and divide it by the square of your height in metres a person with a b.m.i. of 18 to 25 is considered normal. a person with a b.m.i.

between 25 and 30 is overweight and over 30 obese given my height to be considered obese adults have to weigh around 100 kita grams visibly a thanks for having me today thank you what kind of big chair is this here and this is really what it really huge is it because you treat a lot of overweight patients that's true we need those chairs to accommodate our patients so of course we want that our patients with overweight and obesity feel welcomed in our outpatient clinic but on the other hand it's also a very practical reason some patients don't even fit into this chair early so this is really heavy such a heavy can you patients beat that the chair doesn't crash it holds 500 kilograms but you also have to think of the effect distribution so if you have a very central distribution it may be that you don't fit into the chair

a lot of overweight patients and there even some of these patients and you distinguish between just being overweight and morbid obesity why is that because we . make our therapeutic decisions on b.m.i. above 30 for instance which requires more intensive and an earlier intervention compared to the work b.m.i. for instance when you think about overweight patients who always think that they're lazy just sitting around on the couch and watching telly but there are some overweight patients who are really fit take sue move restless for instance and there are studies says jesting that always patients who are fit are better off than slim patients who are not fit but it's very difficult when you're overweight to go into jane. if you can't do any more just do a little bit. today and motion. fitness trainer you'll hear the mourners putting

her class through their paces the people taking part in this exercise session for the overweight are giving it their all day on the show there has been coming to the class since it began and she knows exactly what she's hoping to achieve. this month i'm for i'm just i'm fit to be taking anything. i like aim for sizing any group that doesn't make me feel self-conscious. i'm not really here in the beginning i did feel a little bit nervous coming here. but now i've started to gain self-confidence which is really great this is unfortunately. for many overweight people it can be a bit daunting trying to lose weight going to a gym and working out alongside people who are very fit the team at this gym came up with the idea for a class specifically for those who are overweight. i guess and one of our

members if we'd ever thought about offering a class like that so we sat down thought about it a bit and decided the idea was great it's never been done before the participants or a group of like minded people and they enjoyed inside. it's going great people are having fun while the that's good and just point by taking part in the fit for a big class isn't just fun for many in the group it's been prescribed by their doctor as physical therapy and means they might be able to avoid surgery. and. we're about to have shoulder operation but we got i fit enough so they didn't need them anymore so we worked directly on the problem areas when i was doing exercises that we wouldn't have been able to do a year ago it was very different in the beginning and we're really happy that we've made it to this point and that the participants have made such progress after what i just typed in the most anxious time the organizers are looking to get even more

participants involved in the class or in the midst of a good we're all a little bit overweight and want to work on it it would be good to have more people like us join us we'd love it if more people came to the course. exercising with others who have the same goals. we just saw that the people in our report were exercising to get rid of their excess weight is also an option if you're really really obese and principle everybody can exercise so exercise is part of our basic program for overweight patients and obese people. we have to consider of course potential side effects and risks for very very obese people in our exercise programs when i speak to overweight people in my practice and don't tell them they should eat less and exercise more many of them say well it's all the genes to blame or stressed about the metabolism is a truth about this for the signs indeed

a lack of exercise. over eating is only part of the explanation to become overweight so we think that a slow metabolism also contributes to that the individual body shape or development of overweight for instance some hormone mood disturbances may contribute to overweight such as those thyroid function or increased stress hormone levels. we also know that with aging we need less. calories being overweight is not just about feeling good it's also a big health risk involved and saliva. heart attack even some forms of cancer. what about really obese patients because the risk there so we think that between 30 and 60 diseases are at least associated with obesity some of them are really a function simply of body weight like joint problems lung problems

like obstructive sleep apnea for instance even hypertension these are the seasons which are clear and clear function of the body weight but still we see independent of the body weight starting with overweight for some metabolic diseases including type 2 diabetes fatty liver that weight is only a contributor and we see across the entire range of body weight in increased risk for those metabolic diseases so why is it so hard to lose weight and keep the no weight our body perfectly defense dimmick simle body weight so we have several mechanisms including hormone the neuron and mechanisms protecting us from hunger now in times where we have everywhere food and we don't have to exercise and i will work in transportation modes are. sedentary if you want so. that falls back on us and of course as overweight and obesity what kind of patients come

to you how biko their oh we see patients who have like 5 to 10 kilograms overweight and patients who weigh up to 300 kilograms which wouldn't fit in a chair like this even in this because it's a very very big chair exactly so we even need some time special transportation modes for those patients and it requires 3 to 4. fire over across to help and. report people to come to us for a diagnosis and treatment and what kind of concept do you offer we try to offer our patients and geology based treatment of obesity this of course requires in the 1st place a clear diagnosis which includes hormone of course of obesity metabolism causes of obesity but also psychological cause we are surprised that in many of our patients

psychological courses including also stigmatisation of the society is one of the main courses of obesity so we believe that obesity can be treated it cannot be cured as of today but it's an escalating thorough puting approach so we start with interventions focusing on increasing exercise decreasing food intake we can at pharmacotherapy s. and it may bring patients to the decision to go for beriah trick surgery which is in the long term so far the most effective treatment strategy so surgery like gastric banding for instance or even gastric bypass can make all the difference. less the year goes i've been a youngish he doesn't dreaded climbing stairs she used to weigh $150.00 kilos now she weighs only $95.00 and going up them has become much easier she still has a pair of slacks from the old days how does she feel about them now. if you make

later i feel like. i always cut my weight in hard especially when i see the slacks i know i've reached my goal soft. it was the last straw for her when she found out she needed new knee joints that prompted her to ask for gastric bypass surgery to. she received a so-called on the go loopy gastric bypass the surgeons also had her stomach and small intestine. after that her body could only take in a fraction of the food it was a drastic step. to pretend most of our the patients have to be observed for the rest of their lives they also need lifelong monitoring by the obesity center many have to take vitamin supplements for example they need to be checked regularly to ensure the not suffering from any deficiencies. in the market because absolutely

essential were performing these kinds of operations. sabina's life changed dramatically after the operation she now eats much less she lost more than 50 kilos in 9 months any problems have gone and she started going out for walks again is a suits the 4 star who i know eat more consciously or slowly when my stomach says you're full and i stop even if there's a crumb on the plate or the other half of a roll i leave it there anita again an hour or 2 later. i feel reborn very high. appetite. permanent thanks to the gastric bypass surgery. so there is difficult choices this bending and gastric bypass surgery so so what's the difference so the differences between the obesity surgeries how much we restrict the amount of food which can be taken in. and also with the

absorption of fruit so for instance the gastric banding which restrict the size of the stomach so per meal you can approximate the eat like a smaller amount of maybe 200 grams or milliliters or so. very with with a gastric bypass you have also a restriction of the stomach that is becoming smaller due to the search every but then food goes in deeper parts of the intestine thereby leading to match ups or passion. or a restriction of the absorption at least so if you take a look into the yellow press there are often reports about magic pill and medication that can help you to reduce weight suit so what does an expert say about this many pills under free market which are not really safe and successful but there are a couple of medications which are really approved for the treatment of obesity and

those includes medications who would limit the absorption effect such as or just that for instance and others are predominantly very king under brain centers of epa titan satiety control. and told other results if a patient decides that he wouldn't go for surgery and he would like to take any medication that he just tries to lose weight with lifestyle changes so the effects of the different treatment approaches is quite variable. as the mean you may lose up to 5 percent of your initial bodyweight with diet and exercise interventions pharmacotherapy may provide a 10 to 15 percent of the weight loss but surgeries may provide of weight loss of more than 30 percent 50 percent of your initial bodyweight of course this has to be considered and weighed against the side effects if we have patients who do

not want to go for families with therapy or obesity surgery we know that the best predictors of a treatment success are a tier instead of the profile and high level of motivation. we got a lot of viewer questions like from the heart who wants to know if using weight fast isn't the problem it's not dangerous like for kidneys there are indeed risks associated with fast weight loss particularly for the kidneys therefore we always recommend. that parallel monitoring by physicians or dieticians because too much approaching it with a fast weight loss may be harmful for the kidneys bella flanagan is a teacher in australia and she's noticed an increase of children and she would like to know what she can do about it. indeed particularly in children and adolescents the prevalence of obesity and overweight significantly increased over recent years

. and we know that this is the very sensitive period in your life where you can really make a difference so nutrition education bringing people into exercise programs. also educate about the content of certain food may be critical in this period thank you so much for answering all my questions thank you and what about you you don't have any love handles good for you but maybe you have some questions. in good shape if you're a weekly health show on d w that covers many aspects of health care we look at what's new in medical treatment nutrition fitness and beauty we discuss these topics and depth with specialists and offer you opportunities to pose your own questions so get in touch . at least in modern and enlightened societies the differences between men and women are declining but some gender

specific differences remain. school girls are less confident in math and physics than their male counterparts. even in college majors students are more confident than female students. women are more generous and are more likely to share. and they take better care of their health and therefore they live longer. and because men and women react differently to symptoms medication and disease this is why the field called gender medicine was created. moderately to hoard light and i was one of the 1st doctors and the german speaking world to apply a revolutionary principle to her work because men and women differ biologically they sometimes need different treatments it's not approach that's known as gender

medicine. they are as common as the clergy looking asian my background is in cardiology. the differences are already noticeable in everyday life. sample they tend to be more men in the intensive care unit. of the samyn. that's an odd statistic given that more women die from heart disease than men so where are the female patients. a gender specific perspective is like a magnifying glass that provides completely new insights some of which are vital for patient survival. or. a heart attack manifests itself differently in man and one and it often affects different blood vessels. the. men and women also react differently to certain medications from aspirin to widely

used antihypertensive. the kidneys work differently in men and women too. even the success of cancer treatments depends on the sex of the patients. when it's a found among dunces a woman and the man get the same cancer at the same age and in the same state of health he is then a man has a much higher risk of dying from it if both died the man will die faster men are worse off chemotherapy works better for women. a gender specific perspective has to start with basic medical research suzanna whole fun from the helmholtz center in new york is an expert on diabetes and the different forms it takes in men and women. is that to charles. it

turns out that women have a higher risk of developing diabetes if they are obese. and what's even more serious women also suffer more from secondary diseases and check a light. but why is that what role does estrogen play in this process and how does it interact with cholesterol for example. in order to alleviate the more severe progression of the disease in women the researchers are trying to develop a therapy that allows female patients to exercise more vigorously. this could help prevent the emergence of typical secondary conditions. divine for steere we want to understand how this works because not everyone is able to exercise vigorously it would be great if we could develop a drug supply. the researchers are trying to understand the smallest details of gender differences and use those insights to develop new and improved treatments

. that will mean a reappraisal of well known active ingredients and pharmaceuticals oliver vets from the university of you know is working with his research group on what are known as anti like or trying a class of drugs with huge potential for the treatment of diseases like rheumatism and asthma. at least when tested on female patients have been asked to development of these active substances began in 1980 s. and ninety's but the active substances were always tested on men and then it became clear that their efficacy was actually relatively low energy now look at our data and see that the active substances are much more effective in female cells in female animals you can conclude that they could actually be more effective in women . so medical research shows that are adapting treatment diagnosis and medication to the different needs of men and women there's

a logical step. one that will help take therapies to the next level. in the old days it was all about plugging a hammering into nailing things but nowadays it's become very quiet because we just glue. tended words even for to. breathe alone lost 2 of her teeth to disease at the age of just $35.00 initially she suffered from bleeding gums there enjoying pregnancy her teeth grew loose and eventually fell out. the dentist try to save the teeth but the attempts were unsuccessful the river was told she'd need a denture or implants but then she heard about a decent dentistry. in the new technique that's being used increasingly to replace missing in sizes the reus side of the neighboring tooth is filed slightly to accommodate the replacement tooth which has

a kind of wing on it the dentist this so called a decent bridge to the neighboring tooth and the road is again complete. the implants always require an operation often bone grafting but we generally don't perform any surgery when putting in and he says bridge and we don't need to grind off any healthy tall minimal. so it's less a. it's been 14 years since the reaper got her new teeth just looking at her it's impossible to tell which ones are artificial. 5 . different ones are mine but the ones either side i knew that on one of the edges broken off slightly but i told the dentist not to repair it since it looks natural . with help from an orthodontist fixture the technique can also be used to replace most. we call these bonding attachments of their used to anchor

a partial denture with a piece of. then they can firmly and hold very well. that. they go on sure always try to look after his teeth but as he grew older many of them still fell out. somehow they got infected. to have one tooth out after another until i got to the point where they said i would need full benches. that would have meant having the rest of teeth pulled even though they were still healthy so the 76 year old looked around for a better solution in a kill universities dental school he learned that there was indeed an alternative that would allow him to keep his own teeth. to allow a partial denture to be fitted permanently the dentist bones a tiny pin onto the back of a neighboring tooth the denture has attachments that fit exactly on the pins the

advantage of this system is that it's both invisible and very robust. the technique is not yet widespread but it's already proved to be reliable. this is not new but ya this method has been scientifically proven and a stablished for a number of years if an adhesive bridge or attachment should happen to come loose a little usually be an issue of the bonding which is easy to repair when you know how to monetize a view here let's go to that today it should be a matter of course that dentists inform patients about the option of adhesive dentistry especially adhesive bridges and attachments so that their own teeth don't need to be ground down unnecessarily or if they need an implant that they know there is an alternative. dentistry not only office certain advantages it's often cheaper than other techniques in germany it's already the standard for placing missing in sizes to create natural looking teeth. that's it for today see you next

week and until then let's all try to stay in good shape.

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play the be . this is day to the news live from berlin on call the protests turned violent again allays fire on demonstrators leaving at least one person kingship protest as planned more disruptions throughout the day we'll go to hong kong for the latest also coming up. bolivia's president evo morales has bowed to opposition pressure and resigns promises standing down after weeks of protests over the edge forward in last month's election victory would have given him a 4th consecutive term in office. and.